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Right ventricular remodeling and dysfunction with subsequent annular dilatation and tethering as a mechanism of isolated tricuspid regurgitation

 Hye-Sun Seo  ;  Jong-Won Ha  ;  Jae Youn Moon  ;  Eui-Young Choi  ;  Se-Joong Rim  ;  Yangsoo Jang  ;  Namsik Chung  ;  Won-Heum Shim  ;  Seung-Yun Cho  ;  Sung Soon Kim 
 CIRCULATION JOURNAL, Vol.72(10) : 1645-1649, 2008 
Journal Title
Issue Date
Dilatation, Pathologic/physiopathology ; Echocardiography ; Humans ; Retrospective Studies ; Tricuspid Valve Insufficiency/diagnostic imaging ; Tricuspid Valve Insufficiency/physiopathology* ; Ventricular Dysfunction, Right/diagnostic imaging ; Ventricular Dysfunction, Right/pathology ; Ventricular Dysfunction, Right/physiopathology* ; Ventricular Function, Right/physiology* ; Ventricular Remodeling/physiology*
Cardiomyopathy ; Isolated tricuspid regurgitation ; Right ventricle
BACKGROUND: Secondary tricuspid regurgitation (TR) as a result of pulmonary hypertension and/or left-sided heart disease is caused by tricuspid valve (TV) annular dilatation and tethering of the tricuspid leaflet after right ventricular (RV) dilatation. However, the mechanism of isolated TR without significant pulmonary hypertension remains unknown. The present study investigated the RV function and TV deformations in patients with isolated TR to find out the mechanism and etiology of the disease.

METHODS AND RESULTS: Twelve patients with isolated, severe TR were included. RV area, volume, ejection fraction (EF), tenting distance and tenting area were measured. These parameters were compared with 12 age-and gender-matched controls and 12 patients with secondary TR. The cause of isolated TR was incomplete coaptation associated with annular dilatation without other problems. Compared with the controls, RV end-diastolic volumes and annular diameters were significantly larger and RVEF was significantly lower in patients with isolated TR. Tenting area and tenting distance were also significantly higher. However, there were no significant differences in these parameters between patients with isolated and secondary TR.

CONCLUSIONS: Isolated TR was associated with RV remodeling, systolic dysfunction and resultant annular dilatation and tethering of tricuspid leaflets.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Soon(김성순)
Moon, Jae Youn(문재연)
Shim, Won Heum(심원흠)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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